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目的探讨肝炎后肝硬化自发性细菌性腹膜炎(spontaneous bacterial peritonitis,SBP)的诊疗情况及头孢哌酮舒巴坦联合左旋氧氟沙星对SBP的治疗效果。方法对2004年1月2009年12月收治的54例肝炎后肝硬化SBP患者,应用头孢哌酮舒巴坦联合左旋氧氟沙星给与治疗,并观察分析治疗效果。结果肝炎后肝硬化SBP的临床表现以发热,腹痛为主,具有典型腹膜刺激征的不足半数。外周血白细胞升高者不多见,腹腔积液中白细胞计数、PMN计数和细菌培养是自发性细菌性腹膜炎的重要诊断指标。结论肝炎后肝硬化合并SBP的临床表现不典型。致病菌以G-杆菌为主。在早期诊断、综合治疗的基础上,头孢哌酮舒巴坦联合左旋氧氟沙星对自发性细菌性腹膜炎的治疗效果显著。
Objective To investigate the diagnosis and treatment of spontaneous bacterial peritonitis (SBP) in patients with posthepatitic cirrhosis and the therapeutic effect of cefoperazone and sulbactam combined with levofloxacin on SBP. Methods 54 patients with posthepatitic cirrhosis SBP treated in January 2004 and December 2009 were treated with cefoperazone and sulbactam combined with levofloxacin. The therapeutic effect was observed and analyzed. Results The clinical manifestations of posthepatitic cirrhosis SBP were mainly fever and abdominal pain with less than half of typical peritoneal irritation. Peripheral leukocytosis are rare, white blood cell count in peritoneal effusion, PMN count and bacterial culture is an important diagnostic indicator of spontaneous bacterial peritonitis. Conclusions The clinical manifestations of posthepatitic cirrhosis complicated with SBP are not typical. Pathogenic bacteria to G-bacteria-based. On the basis of early diagnosis and comprehensive treatment, cefoperazone sulbactam combined with levofloxacin has a significant therapeutic effect on spontaneous bacterial peritonitis.